High-risk endoscopic features and therapeutic efficacy of endoscopic treatment of sporadic non-ampullary descending duodenal adenoma
10.3760/cma.j.cn321463-20200710-00812
- VernacularTitle:十二指肠降部非壶腹部散发型腺瘤内镜下的高危征象识别及治疗效果
- Author:
Liangliang SHI
;
Yang LI
;
Lin ZHOU
;
Yonghua SHEN
;
Tingsheng LING
- From:
Chinese Journal of Digestive Endoscopy
2021;38(3):226-230
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and efficacy of endoscopic treatment for sporadic non-ampullary descending duodenal adenoma, and to analyze high-risk endoscopic features of malignant adenoma.Methods:Data of 54 patients diagnosed as having non-ampullary descending duodenal adenoma in Nanjing Drum Tower Hospital from November 2012 to September 2019 were retrospectively studied. The patients were divided into two groups, the high-grade intraepithelial neoplasia/adenocarcinoma (HGIN/AC) group and the low-grade intraepithelial neoplasia (LGIN) group according to pathological grade. Clinical features including gender, age, size and color of lesions, therapeutic methods, complications and postoperative follow-up results were analyzed.Results:A total of 54 patients were divided into the HGIN/AC group ( n=12) and the LGIN group ( n=42). There were significant differences in size or color of lesions between the two groups (both P<0.05). All 54 patients received endoscopic treatment. Biopsy, endoscopic mucosal resection and endoscopic submucosal dissection were performed on 8, 32 and 14 cases, respectively. A small perforation was found and clipped during operation without any complications. There were 2 cases of delayed hemorrhage, and the bleeding stopped under endoscopic treatment. The mean follow-up time was 2-58 months with no recurrence. Conclusion:Endoscopic treatment is safe and effective for non-ampullary descending duodenal adenoma. Lesions of size larger than 10 mm and those with a red surface have higher malignant tendency.
